Multiple-input-coupled illuminated multi-spot laser probe

ABSTRACT

Systems and methods for creating multi-spot laser light beams, multiplexing an illumination light and the multi-spot laser light beams, and delivering the multiplexed light to a surgical handpiece via a multi-core optical fiber cable.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a divisional of U.S. Non-Provisional applicationSer. No. 16/217,346, filed Dec. 12, 2018, which claims the benefit ofand priority to U.S. Provisional Patent Application No. 62/598,653,filed Dec. 14, 2017, and U.S. Provisional Patent Application No.62/597,550, filed Dec. 12, 2017. Each of which is hereby incorporated byreference in its entirety as though fully and completely set forthherein.

BACKGROUND Field of the Disclosure

The present disclosure relates to a multiple-input-coupled illuminatedmulti-spot laser probe, and more specifically to systems and methods forcreating multi-spot laser light beams, multiplexing an illuminationlight and the multi-spot laser light beams, and delivering themultiplexed light to a surgical handpiece via a multi-core optical fibercable.

Description of Related Art

In many ophthalmic procedures a surgeon is required to use a variety ofinstruments in the patient's eye. For example, during a vitreoretinalsurgery, a surgeon oftentimes manipulates a first handpiece fordirecting an illumination light beam onto the retinal surface in orderto view patient anatomy and also manipulates an additional laser probehandpiece for delivering a laser treatment beam for treating the patientanatomy. However, there is a need for a multiple-input-coupledilluminated multi-spot laser probe.

SUMMARY

The disclosed embodiments of the present technology relates tomultiple-input-coupled illuminated multi-spot laser probes, adaptors andother systems for multiplexing an illumination light and multi-spotlaser light, and methods for multiplexing an illumination light andmulti-spot laser light for and delivering the multiplexed light ontopatient anatomy.

Some embodiments of the present technology involve a surgical lasersystem, an illumination light source, a surgical probe assembly, and alaser system port adaptor for creating a multi-spot pattern of laserlight beams, multiplexing the multi-spot pattern of laser light beamswith an illumination light beam, and delivering the multiplexed lightbeam to a surgical probe for simultaneously transmitting illuminationlight and a multi-spot pattern of laser light beams. The laser systemport adaptor can include a first port arm for coupling with a lasersource, a second port arm for coupling with an illumination system, athird port arm for coupling with a fiber optic cable of a laser probe,and a multiplexing intersection region. In some cases, the second portarm and the third port arm are substantially collinear across theintersection region, and the first port arm is substantially orthogonalto the second port arm and the third port arm at the multiplexingintersection region.

The intersection region of the laser system port adaptor can contain adiffractive optical element (DOE) configured to receive a collimatedlaser light beam from the optical element and to create a multi-spotlaser pattern of laser light beams. In some cases, the DOE creates themulti-spot laser pattern of laser light beams as a 2×2 array pattern.

The intersection region can also contain a beamsplitter configured toreflect a plurality of narrow bands of the electromagnetic spectrum oflight that correspond to the wavelengths of laser light emitted by thesurgical laser system. The beamsplitter can further receive both themulti-spot pattern of laser light beams and an illumination beam fromthe illumination system. The beamsplitter can reflect the multi-spotlaser pattern of laser light beams towards the third port arm andtransmit portions of the illumination beam not contained within the atleast two narrow bands of the electromagnetic spectrum towards the thirdport arm. In some cases, the second port arm includes a collimating lensfor collimating the illumination light at the beamsplitter. Also, insome cases the intensity of the laser beams and the intensity of theillumination beam can be adjusted to produce a clear multiplexedmulti-spot laser pattern of laser light beams and illumination beam.

The first port arm can include a ferrule having a diameter configured tosecurely couple within a female port of the laser source and can includean opening for allowing a focused laser spot from the laser source toenter the first port arm. The first port arm can also include an opticalelement for collimating a laser light beam. In some cases, the firstport arm and the optical element have lengths configured to place theoptical element substantially adjacent to the point of the focused laserspot from the laser source. Also, the first port arm can includeexternal threading which, when tightened with a nut, couples the firstport arm with the female port of the laser source and keeps the opticalelement substantially adjacent to the point of the focused laser spotfrom the laser source.

The third port arm can include a condensing lens substantially adjacentto the beamsplitter in the multiplexing intersection region. Thecondensing lens can be selected to focus the multi-spot laser pattern oflaser light beams and the illumination beam onto an interface of theterminal end of a multi-core optical fiber cable of the surgical probeassembly.

The multi-core optical fiber cable can include a first outer coresurrounded by an outer-core cladding and a plurality of inner corescontained within the outer core, each inner core in the plurality ofinner cores surrounded by an inner-core cladding. In some cases, theplurality of inner cores contained within the outer core form a 2×2array that matches a 2×2 multi-spot pattern of laser light beams fromthe DOE.

The materials for the various cores and the various claddings can beselected such that the focused illumination beam is propagated down anentire length of a first outer core of the multi-core optical fibercable and such that each of the laser light beams in the multi-spotlaser pattern of laser light beams is propagated down an entire lengthof one of a plurality of inner cores contained within the outer core.

In some cases, a refractive index of the outer core is greater than arefractive index of the outer-core cladding, a refractive index of eachof the inner cores in the plurality of inner cores is greater than arefractive index of the inner-core cladding, and a refractive index ofeach or the inner cores in the plurality of inner cores is larger thanthe refractive index of the outer-core cladding. Further, the condensinglens can be selected to focus each of the laser beams in the multiplexedmulti-spot pattern of laser light beams onto an interface with arespective inner core in the plurality of inner cores, wherein a spotsize of each of the focused laser beams, an angular spread of each ofthe focused laser beams, a refractive index of the inner core, and arefractive index of the inner-core cladding causes the laser light beamsto spatially fill and propagate through the plurality of inner cores forthe length of the multi-core optical fiber cable.

Likewise, the condensing lens can be selected to focus the illuminationbeam as a light cone with a spot size to fall incident on at least aportion of the first outer core, at least a portion of the plurality ofinner cores, and at least a portion of the inner-core claddings. Thelight cone of the illumination beam can include a narrow half-angleportion of the light cone and a wide half-angle portion of the lightcone. In these cases, the refractive index for the various cores andcladdings of the multi-core optical fiber cable and an angle of thenarrow half-angle and wide half-angle portions of the light cone causesthe illumination beam to spatially fill and propagate the length of theouter core of the multi-core optical fiber cable. Also, the narrowhalf-angle portion of the illumination beam can be confined within theouter core region, and the wide angle portion of the illumination beamis free to propagate within the outer core region, the inner claddingregions, and the inner core regions.

In some cases, the surgical probe assembly includes a ferrule forcoupling with a laser system port adaptor or other multiplexing system.The surgical probe assembly can also include the multi-core fiber cableand a handpiece with a probe tip coupled with the distal end of themulti-core optical fiber cable. The probe tip can have a lens locatedsubstantially at a distal end of the probe tip and the multi-coreoptical fiber cable can terminate in an interface with the lens. Thelens can be selected to translate the geometry of the multiplexedmulti-spot laser pattern of laser light beams and illumination beam fromthe distal end of the multi-core optical fiber cable onto a targetsurface.

Some embodiments of the present technology involve methods ofmultiplexing a multi-spot pattern of laser light beams with anillumination light beam. The methods can involve directing a laser lightbeam to an optical element for collimating the laser light beam anddirecting the collimated laser light beam to a diffractive opticalelement (DOE) to create a multi-spot laser pattern of laser light beams.Likewise, the methods can involve directing the multi-spot pattern oflaser light beams and an illumination light beam to a beamsplitter.Next, the method involves the beamsplitter reflecting the multi-spotpattern of laser light beams towards a condensing lens and transmittingthe illumination light beam to the condensing lens, thereby multiplexingthe multi-spot pattern of laser light beams and a transmittedillumination beam. The methods can also involve the condensing lensfocusing the multiplexed multi-spot pattern of laser light beams andtransmitted illumination beam onto an interface with a multi-coreoptical fiber cable. Also, the methods can involve directing themultiplexed multi-spot pattern of laser light beams and transmittedillumination beam through the multi-core optical fiber cable and onto alens in a probe tip. Next, the lens translates a geometry of themultiplexed multi-spot laser pattern of laser light beams andillumination beam from the distal end of the multi-core optical fibercable onto a target surface.

Some embodiments of the present technology involve methods of creatingan image of a multiplexed beam of multi-spot pattern of laser lightbeams and illumination light. The methods can involve selecting, for amulti-core optical fiber cable, a material with a first refractive indexfor an outer core, a material with a second refractive index for anouter-core cladding, a material with a third refractive index for aplurality of inner cores contained in the outer core, and a materialwith a fourth refractive index for an inner-core cladding for each ofthe plurality of inner cores. The methods can also include determining anumerical aperture of laser light beams from a laser source and anumerical aperture of an illumination light beam from an illuminationlight source, and selecting a condensing lens to focus the multiplexedmulti-spot pattern of laser light beams and illumination beam onto aninterface plane of the multi-core optical fiber cable. Next, the methodscan include multiplexing a multi-spot pattern of laser light beams withthe illumination light beam and focusing the multiplexed multi-spotpattern of laser light beams and illumination beam onto an interfaceplane of the multi-core optical fiber cable such that the illuminationbeam propagates down the outer core and the laser beams propagate downthe multiple inner cores. The methods can also involve directing themultiplexed beam of multi-spot pattern of laser light beams andillumination light through a lens in the surgical handpiece.

Some embodiments of the present technology involve an integratedillumination and multi-spot laser multiplexing system. The integratedsystem can include a laser source that emits a collimated laser lightbeam and a diffractive optical element (DOE) configured to receive thecollimated laser light beam and to create a multi-spot laser pattern.The integrated system also includes an illumination system that emitssubstantially white light and a collimating lens that collimates thesubstantially white light received from the illumination system. Theintegrated system further includes a fiber optic cable port that couplesa multi-core optical cable fiber to the system and a beamsplitter thatreflects the multi-spot laser pattern towards a condensing lens and thattransmits the collimated illumination beam towards the condensing lens,thereby multiplexing the multi-spot laser light beams and theillumination light beam. The condensing lens can further focus themultiplexed multi-spot pattern of laser light beams and illuminationbeam onto an interface with the fiber optic cable port, through amulti-core optical fiber cable, and onto a lens in the tip of a surgicalhandpiece that translates a geometry of the multiplexed multi-spot laserpattern of laser light beams and illumination beam onto a targetsurface.

Some embodiments of the present technology involve an integratedillumination and multi-spot laser multiplexing system. The system caninclude a laser source that emits a collimated laser light beam, adiffractive optical element (DOE) to create a multi-spot laser patternof laser light, an illumination system that emits substantially whitelight, and a collimating lens that collimates the substantially whitelight received from the illumination system. The system further includesa beamsplitter that reflects the collimated laser light beam and thattransmits the collimated illumination beam towards a condensing lens.The DOE creates a multi-spot laser pattern of laser light beams and thebeamsplitter multiplexes the pattern of laser light beams and theillumination light beam. The system further includes a fiber optic cableport that couples the multiplexed light with a multi-core optical cablefiber.

BRIEF DESCRIPTION OF THE DRAWINGS

For a more complete understanding of the present technology, itsfeatures, and its advantages, reference is made to the followingdescription, taken in conjunction with the accompanying drawings, inwhich:

FIG. 1 illustrates a system for creating a multi-spot pattern of laserlight beams, multiplexing the multi-spot pattern of laser light beamswith an illumination light beam, and delivering the multiplexed lightbeam to a surgical probe in accordance with a particular embodiment ofthe present disclosure;

FIG. 2A illustrates a laser system port adaptor in accordance with aparticular embodiment of the present disclosure;

FIG. 2B illustrates the laser system port adaptor coupled with asurgical laser system and an illumination light source in accordancewith a particular embodiment of the present disclosure;

FIG. 3 illustrates a method for multiplexing a multi-spot pattern oflaser light beams and illumination light in accordance with a particularembodiment of the present disclosure;

FIG. 4A-4B illustrate systems including a light multiplexing componentcontaining a laser source and an illumination light source in accordancewith a particular embodiment of the present disclosure;

FIG. 4C illustrates a system that includes a laser light multiplexingmodule containing a laser source and an illumination module thatincludes an illumination light source in accordance with a particularembodiment of the present disclosure;

FIG. 5A illustrates the top view of a terminal end of a multi-coreoptical fiber cable in accordance with a particular embodiment of thepresent disclosure;

FIG. 5B illustrates a side view of the interface of a plurality of lightcones onto a multi-core optical fiber cable in accordance with aparticular embodiment of the present disclosure;

FIG. 5C illustrates the cut-away view of a multi-core optical fibercable according to some embodiments of the present technology inaccordance with a particular embodiment of the present disclosure.

FIG. 5D illustrates a proximal, interface end of a multi-core opticalfiber cable with laser beam spots lining up with the inner cores and anillumination light beam spot lining up with the outer core in accordancewith a particular embodiment of the present disclosure;

FIG. 5E illustrates the distal end of a multi-core optical fiber cablewith all three beams spread out to totally spatially fill theirrespective cores in accordance with a particular embodiment of thepresent disclosure;

FIGS. 5F-5M illustrate the propagation of the multiplexed light througha multi-core optical fiber cable in accordance with a particularembodiment of the present disclosure;

FIG. 6A-6B illustrate an open side views of tips of a surgical handprobe in accordance with a particular embodiment of the presentdisclosure;

FIG. 7 illustrates a method of creating an image of a multiplexed beamof multi-spot pattern of laser light beams and illumination light inaccordance with a particular embodiment of the present disclosure;

FIG. 8A illustrates an end view of a multi-lumen tubing for deliveringmultiplexed laser aiming and treatment beams and a laser illuminationlight beam in accordance with a particular embodiment of the presentdisclosure;

FIG. 8B illustrates each of the laser aiming and treatment beams as wellas the laser illumination light beam spatially underfilling theirrespective fiber cores at the proximal end in accordance with aparticular embodiment of the present disclosure;

FIG. 8C illustrates each of the laser aiming and treatment beams as wellas the laser illumination light beam spatially totally filling theircores at the distal end in accordance with a particular embodiment ofthe present disclosure; and

FIG. 8D illustrates a distal end of a nanofiber extending past an arrayof glass fibers in the multi-lumen tubing at or near a focusing lens inaccordance with a particular embodiment of the present disclosure.

DESCRIPTION

In a wide variety of medical procedures, laser light is used to assistthe procedure and treat patient anatomy. For example, a vitreoretinalsurgery oftentimes involves using a laser treatment beam forphotocoagulation of retinal tissue. Vitreoretinal procedures commonlyinvolve a laser probe that is capable of alternately emitting an aiminglaser beam to select target spots on retinal tissue and emitting atreatment laser beam to perform the photocoagulation at the targetedspots. Frequently, the laser probe utilizes light in a red band of theelectromagnetic spectrum for the aiming beam and light in a green bandof the electromagnetic spectrum for the treatment beam. Also, during apanretinal laser photocoagulation procedure, a surgeon selects thousandsof spots on retinal tissue to apply the treatment laser beam to,resulting in a very long and tedious procedure. Therefore, a laser probecapable of producing a multi-spot pattern of laser light is desirable.

Vitreoretinal procedures also benefit from illumination light beingdirected into the eye and onto retinal tissue. Vitreoretinal surgeonsoftentimes use a laser probe handpiece for delivering the laser aimingand treatment beams and also use an additional handpiece for directingan illumination light beam onto the retinal surface in order to viewpatient anatomy.

The field of vitreoretinal surgery, as well as other medical laserprocedures, would benefit from multiplexing an illumination light andmulti-spot laser light. Accordingly, the technology described hereininvolves multiple-input-coupled illuminated multi-spot laser probes,adaptors and other systems for multiplexing an illumination light andmulti-spot laser light, and methods for multiplexing an illuminationlight and multi-spot laser light and delivering the multiplexed lightonto patient anatomy.

FIG. 1 illustrates a system 100 for creating a multi-spot pattern oflaser light beams, multiplexing the multi-spot pattern of laser lightbeams with an illumination light beam, and delivering the multiplexedlight beam to a surgical probe 115 for simultaneously transmittingillumination light and a multi-spot pattern of laser light beams inaccordance with a particular embodiment of the present disclosure.

The system 100 includes a surgical laser system 105 that includes one ormore laser sources for generating laser beams used during an ophthalmicprocedure. For example, the ophthalmic surgical laser system 105 canalternatively generate a surgical treatment beam with a wavelength ofaround 532 nanometers (nm) and a laser aiming beam with a wavelength ofaround 635 nm. A surgeon or surgical staff member can control thesurgical laser system 105 (e.g., via a foot switch, voice commands,etc.) to alternatively emit the laser aiming beam and fire the treatmentbeam to treat patient anatomy (e.g., perform photocoagulation). Thelaser beams can be emitted through a port 106 in the surgical lasersystem 105.

The system 100 also includes an illumination light source 110 that caninclude one or more of a xenon illumination, an RGB light-emitting diode(LED) illuminator, a white light LED illuminator, a laser-pumpedphosphor illuminator, a supercontinuum white laser illuminator, etc. Theillumination light source 110 can be a surgical console that can monitorand control a wide variety of aspects of an ophthalmic procedure. Forexample, the surgical console can be configured for use in vitreoretinalsurgery and can power and control vitrectomy probes, can integratepressurized infusion delivery and intraocular pressure compensation, canprovide surgical illumination, etc. In some cases, the illuminationlight source 110 can deliver the illumination light via an illuminationcable 111.

The system 100 also includes a laser system port adaptor 150 containingoptical elements (not shown) for creating a multi-spot pattern of laserlight beams from a laser light beam from the ophthalmic surgical lasersystem 105 and multiplexing the multi-spot pattern of laser light beamswith an illumination light beam received from the illumination lightsource 110. The adaptor 150 can include a plurality of port arms 152,154, 156 that couple with the surgical laser source 105, theillumination light source 110, and to the surgical probe 115,respectively.

The system 100 can deliver the multiplexed light beam from the port arm156 to the surgical probe 115 via a multi-core optical fiber cable 130to provide the surgical probe 115 the ability of simultaneouslyproviding illumination light and a multi-spot pattern of laser lightbeams to the retina 120 of a patient's eye 125. The surgical probe 115includes a probe body 135 and a probe tip 140 that house and protect themulti-core optical fiber cable 130. A distal end 145 of the probe tip140 also contains a lens (not shown, described in greater detail below)that translates the multiplexed light beam from the distal end of themulti-core optical fiber cable onto the retina 120.

As disclosed herein, various systems and methods can be employed forcreating a multi-spot pattern of laser light beams multiplexing themulti-spot pattern of laser light beams with an illumination light beam.As briefly mentioned above, in some cases, a port adaptor can containoptical elements for creating a multi-spot pattern and multiplexinglight beams. FIG. 2A illustrates a laser system port adaptor 250according to some embodiments of the present disclosure. The lasersystem port adaptor 250 includes a first port arm 252 for coupling witha laser source, a second port arm 254 for coupling with an illuminationsystem, and a third port arm 256 for coupling with a fiber optic cableof a laser probe. The laser system port adaptor 250 also includes amultiplexing intersection region 280 where the first port arm 252, thesecond port arm 254, and the third port arm 256 intersect. In somecases, the second port arm 254 and the third port arm 256 aresubstantially collinear across the multiplexing intersection region 280,and the first port arm 252 is substantially orthogonal to the secondport arm 254 and the third port arm 256 at the multiplexing intersectionregion 280.

The first port arm 252 includes a ferrule 258 that functions as a malecoupling for a female chimney port (not shown) of the laser system. Theferrule 258 has an opening 262 that allows laser light from the lasersource to enter the first port arm 252. Also, the ferrule 258 can housean optical element 264 contained within the ferrule 258. The opticalelement 264 is configured to collimate laser light received from thelaser source. For example, the optical element 264 can be a graded-index(GRIN) lens with a length and a pitch selected such that the opticalelement 264 collimates laser light received at the opening 262 at aselected distance adjacent to a diffractive optical element (DOE) 282contained within the multiplexing intersection region 280, as describedin more detail below.

The first port arm 252 also includes an external threading 260 to drawthe first port arm substantially all the way into the female port of thesurgical laser system 105 when a nut is tightened on the externalthreading. In some cases, the optical element 264 is positioned withinthe ferrule 258 that is flush with the opening 262, and the surgicallaser system 105 is configured to focus a laser spot at the terminal endof the female port. Accordingly, the external threading 260 canfacilitate the optical element 264 being positioned at a point relativeto the surgical laser system 105 such that a focused laser spot of alaser produced by the surgical laser system falls substantially incidentonto the end of the optical element 264.

The second port arm 254 for coupling with an illumination system cancomprise a female port having a substantially cylindrical external frame266, an internal cavity 268, a collimating lens 270 at a first end ofthe internal cavity 268, and an opening 272 at the second end of theinternal cavity 268. The internal cavity 268 of the second port arm 254can be configured to receive a ferrule of an optical cable 111 thatdelivers an illumination light beam from the illumination light source110. In some cases, the ferrule of the optical cable that delivers anillumination light beam is secured to the second port arm 254 with a nutsuch that the illumination emitted from an optical fiber containedwithin the optical cable spreads to fall incident onto the collimatinglens 270 such that the collimating lens 270 delivers substantiallycollimated illumination light to a beamsplitter 284 contained in themultiplexing intersection region 280.

The third port arm 256 for coupling with a fiber optic cable of a laserprobe can comprise a female port having a substantially cylindricalexternal frame 274, an internal cavity 276, a condensing lens 278 at afirst end of the internal cavity 276, and an opening 275 at the secondend of the internal cavity 276.

The internal cavity 276 of the third port arm 256 can be configured toreceive a ferrule of a multi-core optical fiber cable 130 that deliversmultiplexed light to the surgical probe 115, as explained in greaterdetail below. In some cases, the ferrule of a multi-core optical fibercable is secured to the third port arm 256 with a nut such that thecondensing lens 278 precisely focuses the multiplexed light onto aninterface 290 of the terminal end of the multi-core optical fiber cablesuch that an illumination beam and laser aiming/treatment beams arepropagated down an entire length of the multi-core optical fiber cable,as explained in greater detail below.

As explained above, the laser system port adaptor 250 also includes amultiplexing intersection region 280 where the first port arm 252, thesecond port arm 254, and the third port arm 256 intersect. Themultiplexing intersection region can contain a diffractive opticalelement (DOE) 282 configured to receive a collimated laser light beamfrom the optical element 264 of the first port arm 252 and to create amulti-spot laser pattern of laser light beams. The DOE 282 can beselected to diffract incident laser light into a multi-spot pattern thatwill align with an intended target geometry. For example, the DOE 282can be selected to create a 2×2 array pattern of laser light beams thatsubstantially matches a 2×2 array of inner cores of a multi-core opticalfiber cable that delivers the multiplexed light to the surgical probe115, as explained in greater detail below.

The multiplexing intersection region 280 also contains a beamsplitter284 configured to reflect a portion of the light spectrum and transmit aremaining portion of the light spectrum. More specifically, thebeamsplitter 284 can be configured to both: a) reflect laser aiming andtreatment beams from the surgical laser system 105 toward the third portarm 256 and the condensing lens 278, and b) transmit the illuminationlight from the illumination light source 110 toward the third port arm256 and the condensing lens 278. Also, as mentioned above, thecondensing lens 278 can be selected to precisely focus the multiplexedlight onto an interface 290 of the terminal end of the multi-coreoptical fiber cable 130 such that an illumination beam and laseraiming/treatment beams are propagated down an entire length of themulti-core optical fiber cable 130, as explained in greater detailbelow.

As explained above, vitreoretinal procedures frequently utilize light ina red band of the electromagnetic spectrum for a laser aiming beam andlight in a green band of the electromagnetic spectrum for a lasertreatment beam. Accordingly, the beamsplitter 284 can be configured tohighly reflect light in a narrow band of the red spectrum and a narrowband of the green spectrum and configured to transmit the remainingelectromagnetic spectrum. In some embodiments, the beamsplitter 284reflects light in a first narrow band around 532 nanometers (nm) and ina second narrow band around 635 nm and transmits the remaining spectrum.The beamsplitter 284 can be a dichroic beamsplitter cube, a beamsplitterplate, etc.

Since portions (e.g., red and green portions) of the illumination lightfrom the illumination light source 110 are reflected by the beamsplitter284, the system port adaptor 250 can include a light collection module286. For example, the light collection module 286 can be a beam dump,power monitor, etc.

FIG. 2B illustrates the laser system port adaptor 250 coupled with asurgical laser system 205, a ferrule 212 of an optical cable 111 thatdelivers an illumination light beam from the illumination light source110, and a ferrule 132 of the multi-core optical fiber cable 130 thatdelivers multiplexed light to the surgical probe 115.

The surgical laser system 205 includes a female port 202 with an opening206 in the proximal end of the female port 202 that allows laser lightto exit the surgical laser system 202. The female port 202 is configuredto receive the first port arm 252 of the laser system port adaptor 250such that the optical element 264 in the first port arm 252 issubstantially adjacent to the opening 206. The surgical laser system 205is configured to focus laser light substantially onto an interface planeat the opening 206 and the optical element 264. Also, a nut 204 can beused to secure the laser system port adaptor 250 with the surgical lasersystem 205 and maintain the proximity of the optical element 264 withthe opening 206 in the female port 202.

As explained above, an ophthalmic surgical laser system 105 canalternatively generate a surgical treatment beam with a wavelength ofaround 532 nanometers (nm) (i.e., green) and a laser aiming beam with awavelength of around 635 nm (i.e., red). However, red and green incidentlaser light diffract off a DOE with different diffraction angles. Whenthe laser beams are not collimated then their focus is also affected,i.e. red and green will focus at different axial locations. This greatlycomplicates trying to focus both green and red laser beams into the sameinner-core regions of the multi-core fiber, as explained in greaterdetail below. Therefore, some embodiments involve collimating themultiple beams that fall incident on the DOE so that the multiple beamsgenerated from the DOE are also collimated. To achieve a multi-spotlaser pattern with sufficient focus, the laser light from the surgicallaser system 205 should be collimated when it falls incident on the DOE282. Therefore, in some cases, the optical element 264 can selected tobe long enough (e.g., 16.54 mm) to collimate laser light from thesurgical laser system 205, bring the laser light back into focus, andcollimate the laser light a second time such that the laser light iscollimated at the DOE 282.

In some cases, the optical element 264 is a 0.75 pitch, 0.20 NA GRINrelay lens that receives laser focused input beam and outputs acollimated beam at the distal end of the GRIN lens. The GRIN lens islong enough to collimate the beam then bring it to a focus and thencollimate is a second time. In some other cases, the optical element 264is a refractive-lens relay system.

The DOE 282 receives the collimated laser light and creates a multi-spotpattern of laser light beams. For example, in some cases, the DOE 282can create a 2×2 array pattern of laser light beams that substantiallymatches a 2×2 array of inner cores of the multi-core optical fiber cable130 that delivers the multiplexed light to the surgical probe 115, asexplained in greater detail below. In some other cases, the DOE 282 canbe replaced by an assembly of prisms and/or beamsplitters to create themulti-spot pattern of laser light beams.

As also shown in FIG. 2B, the second port arm 254 of the laser systemport adaptor 250 is also coupled with a ferrule 212 of an optical cable111 that delivers an illumination light beam from the illumination lightsource 110. In some cases, the length of the internal cavity of thesecond port arm 254 is selected such that a terminal end of an opticalfiber contained within the optical cable 111 is positioned apredetermined distance from the collimating lens 270. The collimatinglens 270 and/or the predetermined distance of the optical fiber from thecollimating lens 270 can be selected such that the illumination light issubstantially fully collimated at the beamsplitter 284. Also, a nut cansecure the ferrule 212 in the internal cavity 268 and maintain thepredetermined distance of the optical fiber 218 from the collimatinglens 270.

Also, as mentioned above, the beamsplitter 284 can be configured toboth: a) reflect laser aiming and treatment beams from the surgicallaser system 105 toward the third port arm 256 and the condensing lens278, and b) transmit the illumination light from the illumination lightsource 110 toward the third port arm 256 and the condensing lens 278.

As also shown in FIG. 2B, the third port arm 254 of the laser systemport adaptor 250 is coupled with a ferrule 132 of the multi-core opticalfiber cable 130 that delivers multiplexed light to the surgical probe115. Also, the condensing lens 278 can be selected to precisely focusthe multiplexed light onto an interface 290 of the terminal end of themulti-core optical fiber cable 130 such that an illumination beam andlaser aiming/treatment beams are propagated down an entire length of themulti-core optical fiber cable 130, as explained in greater detailbelow.

FIG. 3 illustrates a method 300 for multiplexing a multi-spot pattern oflaser light beams and illumination light in accordance with a particularembodiment of the present disclosure. The method 300 involvescollimating a laser light beam by directing a laser light beam to agraded-index (GRIN) lens at step 305, creating a multi-spot pattern oflaser light beams by directing the collimated laser light beam onto adiffractive optical element (DOE) at step 310, and directing themulti-spot pattern of laser light beams to a beamsplitter at step 315.

The method 300 also involves collimating an illumination beam using acollimating lens at step 320 and directing the collimated illuminationbeam to the beamsplitter at step 325. Next, the method 300 involvesmultiplexing, using the beamsplitter, the multi-spot pattern of laserlight with the collimated illumination beam at step 330. Morespecifically, in some cases, multiplexing the multi-spot pattern oflaser light with the collimated illumination beam can involve thebeamsplitter reflecting laser aiming and treatment beams from thesurgical laser system toward a condensing lens and transmitting theillumination light from the illumination light source towards thecondensing lens.

The method 300 also involves focusing, with a condensing lens, themultiplexed beam of multi-spot pattern of laser light and illuminationlight onto an interface with a multi-core optical fiber cable of asurgical handpiece at step 335 and, subsequently, directing themultiplexed beam of multi-spot pattern of laser light beams andillumination light through a lens in the surgical handpiece at step 340,as described in more detail below.

In some cases, the intensities of the white illumination and the laseraiming beams can be adjusted (e.g., at the illumination light source andsurgical laser system, respectively) to provide the right amount oflaser aiming beam contrast against the white while providing enoughwhite illumination to easily see the retina.

The system 100 illustrated in FIG. 1 and described herein involves amodular approach with a separate surgical laser system and illuminationlight source. However, in some cases, the surgical laser system andillumination light source can be integrated in a single module and themodule can contain the appropriate optics for creating a multi-spotpattern of laser light beams, multiplexing the multi-spot pattern oflaser light beams with an illumination light beam, and delivering themultiplexed light beam to a surgical probe for simultaneouslytransmitting illumination light and a multi-spot pattern of laser lightbeams.

FIG. 4A illustrates a system 400 that includes a light multiplexingcomponent 402 containing a laser source 405 and an illumination lightsource 410 in accordance with a particular embodiment of the presentdisclosure. The laser source can generate substantially collimated laserbeams (e.g., red aiming beams, green treatment beams) and direct thelaser beams towards a beamsplitter 484. Also, a linear slide 450 (orrotating wheel) can be positioned in the beam path between the lasersource 405 and the beamsplitter 484. The linear slide 450 can includemultiple optical features that can be alternatively slid into the beampath between the laser source 405 and the beamsplitter 484. For example,the linear slide 450 can include a diffractive optical element (DOE)that creates a multi-spot pattern of laser light beams and a clearwindow or a hollow section that allows the laser light to pass throughunaffected, resulting in a single spot laser beam.

The illumination light source 410 can be a white LED, an RGB LED, axenon laser, a pumped phosphor laser, discreet lasers, supercontinuumlaser, etc. The illumination light source can generate and directillumination light to a collimating lens 470 and towards thebeamsplitter 484.

The beamsplitter 484 can be configured to both reflect laser aiming andtreatment beams from the laser source 405 toward a condensing lens 478and transmit the collimated illumination light from the illuminationlight source 410 toward the condensing lens 478. The condensing lens 478can be selected to precisely focus the multiplexed light onto aninterface 490 of the terminal end of the multi-core optical fiber cable430 such that an illumination beam and laser aiming/treatment beams arepropagated down an entire length of the multi-core optical fiber cable430 and into a surgical hand piece 415, as explained in greater detailbelow.

FIG. 4B illustrates another system 400′ that includes a lightmultiplexing component 402′ containing a laser source 405 and anillumination light source 410. Here, the beamsplitter 484 can multiplexlaser light from the laser source 405 and collimated illumination lightfrom the illumination light source 410 before the multiplexed light beamfalls incident on a rotating wheel 450′. When the rotating wheel 450positions a DOE into the beam path, the DOE can create a multi-spotpattern of laser light beams within the illumination light. Also, thesystem 400′ can include a condensing lens 478 to focus the multiplexedlight beam onto an interface 490 of the terminal end of the multi-coreoptical fiber cable 430

FIG. 4C illustrates another system 499 in accordance with a particularembodiment of the present disclosure that includes a laser lightmultiplexing module 403 containing a laser source 405 and anillumination module 407 that includes an illumination light source 410.The illumination module 407 includes a collimating lens 409 thatcollimates light from the light source 410 and a slidable mirror 411that can be alternatively positioned into and out of the beam path ofcollimated light from the collimating lens 409. When the slidable mirror411 is positioned within the beam path of collimated light from thecollimating lens 409, the slidable mirror directs the collimated lightto a fiber optic coupling 413 and into a fiber optic delivery cable 417.When the slidable mirror 411 is positioned out of the beam path ofcollimated light from the collimating lens 409, the collimated light isdirected to a condensing lens 419 that focuses the light into a fiberoptic cable 421 that is coupled to an illumination probe 423 used fordelivery of purely illumination light.

The fiber optic delivery cable 417 delivers the illumination light fromthe illumination module to a collimating lens 425 in the laser lightmultiplexing module 403. The collimating lens 425 collimates theillumination light and directs the collimated light to a beamsplitter427. Also, the laser source 405 directs substantially collimated (i.e.,substantially collimated due to the substantially point-source nature ofthe laser light from the laser light source 405) to the beamsplitter427. The beamsplitter 427 is configured to transmit a portion of thelight spectrum that corresponds to the wavelengths emitted by the lasersource (e.g., red and green laser light) and configured to reflect aremaining portion of the light spectrum. More specifically, thebeamsplitter 427 can be configured to both reflect laser aiming andtreatment beams from the laser source 405 and transmit the illuminationlight from the collimating lens 425. In this configuration thebeamsplitter 427 effectively multiplexes laser light from the lasersource 405 and collimated illumination light from the illumination lightsource 410. The multiplexed light beam falls incident on a linear slide450 that alternatively positions a DOE into the beam path to create amulti-spot pattern of laser light beams within the illumination light.Also, the laser light multiplexing module 403 includes a condensing lens429 to focus the multiplexed light beam onto an interface 490 of theterminal end of the multi-core optical fiber cable 430 for delivery tosurgical hand piece 415.

In some cases, the light multiplexing components 402, 402′ and/or thelaser light multiplexing module 403 are also integrated into a surgicalconsole that include means for controlling aspects of a surgicalprocedure. For example, the light multiplexing components 402, 402′and/or the laser light multiplexing module 403 can be integrated withina surgical console configured for use in vitreoretinal surgery that canpower and control vitrectomy probes, can integrate pressurized infusiondelivery and intraocular pressure compensation, can provide surgicalillumination, etc. Also, in some cases, the light multiplexingcomponents 402, 402′ and/or the laser light multiplexing module 403 area stand-alone modules that can be used alongside a surgical console.

As mentioned above, a condensing lens can be selected to precisely focusthe multiplexed light onto an interface of the terminal end of themulti-core optical fiber cable such that an illumination beam and laseraiming/treatment beams are propagated down an entire length of themulti-core optical fiber cable and into a surgical hand probe. Morespecifically, the condensing lens can be selected such that resultinglight cones of light from the illumination beam and laseraiming/treatment beams have an acceptance angle and a numerical aperture(NA) to interface with the various fiber core and cladding materialsused in the multi-core optical fiber cable such that the illuminationbeam and the laser aiming/treatment beams are propagated down theappropriate core fibers the entire length of the multi-core opticalfiber cable.

FIG. 5A illustrates the top view of a proximal end of a multi-coreoptical fiber cable 530 according to some embodiments of the presentdisclosure. The multi-core fiber cable 530 can include four inner corefibers 505 with a relatively small-diameter and a relatively small NAinside of an outer core fiber 510 having a relatively large diameter anda relatively large NA. The outer core fiber 510 can be contained withinan outer-core cladding 515 with refractive index (n_(clad1)) and theinner core fibers 505 can be contained within an inner-core cladding 520with refractive index (n_(clad2)). Also, the outer core 510 has a corediameter (d_(core2)) and the inner cores 505 can have a core diameter(d_(core1)).

FIG. 5B illustrates a side view of the interface of a plurality of lightcones 535, 540, 545 onto a terminal end of a multi-core optical fibercable 530 according to some embodiments of the present disclosure. Themulti-core optical fiber cable 530 in FIG. 5B shows the outer core fiber510 and two of the inner core fibers 505. For the sake of image clarity,the outer-core cladding 515 and the inner-core cladding 520 is notdepicted in FIG. 5B. Also represented are a wide-angle portion of theillumination light cone 535, a narrow-angle portion of the illuminationlight cone 540, and the laser light cone 545. The selection of thecondensing lens is related to the half-angle of each of the light cones.Therefore, selecting a condensing lens can involve selecting acondensing lens based on the NA of the light, the acceptance angle ofthe light cones, and the refractive indices of the materials of theouter core fiber 510, the outer-core cladding 515, the inner core fibers505, and the inner-core cladding 520.

The condensing lens is designed to focus laser light down onto themulti-core fiber interface with the desired beam NA. The refractiveindices of the inner core fibers 505 and inner cladding-core claddings520 are selected according to an NA calculation (shown below) so thatthe NA of the inner cores is equal to or greater than the beam NA,thereby ensuring confinement of the beams within the inner core regionsas they propagate down the lengths of the inner core fibers 505.

Referring again to FIG. 5A, a refractive index (n_(core2)) of the outercore fiber 510 is greater than a refractive index (n_(clad2)) of theouter-core cladding 515. Also, a refractive index (n_(core1)) of each ofthe inner cores fibers 505 is greater than a refractive index(n_(clad1)) of the inner-core cladding 520. Further, the refractiveindex (n_(core1)) of each or the inner cores fibers 505 is larger thanthe refractive index (n_(clad1)) of the outer-core cladding 515.

The numerical aperture (NA₂) for the outer core fiber 510 and theouter-core cladding 515 can be calculated as:

NA₂=√{square root over ((n _(core2))²−(n _(clad2))²)}

Likewise, the numerical aperture (NA₁) for the inner core fibers 505 andthe inner-core cladding 520 can be calculated as:

NA₁=√{square root over ((n _(core1))²−(n _(clad1))²)}

In some embodiments of the present disclosure, the materials for theouter core fiber 510, the outer-core cladding 515, the inner core fibers505, and the inner-core cladding 520 are selected such that NA₂ is muchlarger than NA₁. In a specific embodiment, the outer core can be anundoped fused silica with an index of substantially 1.46.

Also, in some embodiments, the red aiming laser beam has an NA of about0.044 and the green treatment laser beam has an NA of about 0.0657.Therefore, as long as the numerical aperture (NA₁) for the inner corefiber 505 is larger than 0.0657, the red and green laser beams willremain confined within the inner cores 505 as they propagate down theprobe. So, a silica fiber with an NA of 0.22 used for the outer core 510may confine the laser beams.

Also, the illumination light can have an NA of around 0.63 and the corediameter can be configured to under-fill or match d_(core2). Thenumerical aperture (NA₂) for the outer core fiber 510 and the outer-corecladding 515 can be designed to have a fiber NA≥0.63, e.g. aborosilicate fiber construction.

When the illumination beam etendue is greater than outer core 510etendue, then coupling efficiency into outer core 510 is less than onehundred percent regardless of condenser lens focal length choice.However, if the illumination beam etendue (which is the product of theillumination beam angular width and spot width) is less than the outercore 510 etendue, then one hundred percent coupling efficiency(neglecting Fresnel reflection losses) can occur if the condensing lensfocus is designed correctly. If the condensing lens has too short of afocus, the converging beam may have an NA greater than core 510 NA, andcoupling efficiency may be degraded. If the condensing lens has too longof a focal length, then the focused beam diameter may be larger than the510 diameter, and coupling efficiency may be degraded. However if thecondensing lens focal length is adjusted so that beam NA is less than orequal to the fiber NA, and the beam diameter is less than or equal tothe fiber core diameter, then one hundred percent or near one hundredpercent coupling efficiency can occur.

Therefore, the illumination beam may both spatially and angularlyunderfill the outer core 510, which will permit spatial and angularmisalignments without a loss of coupling efficiency. Also, since theillumination beam NA is >>NA 1, off-axis rays can frequently pass in andout of the inner cores 505 and inner core cladding 520 as the rayspropagate down the length of the multi-core optical fiber cable 530.

FIG. 5C illustrates the cut-away view of a multi-core optical fibercable 550 according to some embodiments of the present disclosure. Themulti-core fiber cable 550 includes four fused silica inner core fibers505 with a 75 micrometer diameter and a numerical aperture (NA) of 0.22inside of a non-doped fused silica outer core fiber 510 having a 300micrometer diameter and an NA of 0.47. The outer core fiber 510 can becontained within low-index polymer cladding 515 having a 25 micrometerthickness and the inner core fibers 505 can be contained withinfluorine-doped fused silica inner-core cladding 520 having a 15micrometer thickness. The multi-core optical fiber cable 550 can befurther contained in an Ethylene Tetrafluoroethylene (ETFE) coating 575.

The four fused silica inner core fibers 505 have a refractive index of1.46 at 532 nanometers. The non-doped fused silica outer core fiber 510have a refractive index of 1.46 at 532 nanometers. The fluorine-dopedfused silica inner-core cladding 520 can have a refractive index of1.4433 at 532 nanometers. The low-index polymer cladding 515 can have arefractive index of 1.38228 at 532 nanometers.

FIG. 5D illustrates a proximal, interface end of the multi-core opticalfiber cable with a red laser aiming beam spot 506 and a green lasertreatment beam spot 507 lining up with the inner cores 505 and theillumination light beam spot 508 lining up with the outer core 510. FIG.5E illustrates the distal end of the multi-core optical fiber cable withall three beams spread out to totally spatially fill their respectivecores. FIGS. 5F-5L illustrate the propagation of the multiplexed lightthrough the multi-core optical fiber cable.

FIG. 5F illustrates a proximal, interface end of the multi-core opticalfiber cable with a red laser aiming beam spot 506 and a green lasertreatment beam spot 507 lining up with the inner cores 505. FIG. 5Gillustrates two light cones from the multi-spot pattern of laser light(with the multiplexed illumination light emitted for image clarity)propagating down the lengths of a multi-core optical fiber cable. FIG.5H illustrates the laser beams spread out to totally spatially fill theinner cores 505. Similarly, FIG. 5I illustrates the distal end of themulti-core optical fiber cable with the laser beams spread out tototally spatially fill the inner cores 505.

FIG. 5J illustrates a proximal, interface end of the multi-core opticalfiber cable with the illumination light spot lining up with the outercore 510. FIG. 5K illustrates a light cone of the illumination light(with the multiplexed multi-spot pattern of laser light beams emittedfor image clarity), with the light cone including a narrow half-angleportion of the light cone and a wide half-angle portion. The narrowhalf-angle portion of the light cone propagates the lengths of the outercores 510, but is excluded from the inner cores 505. The wide half-angleportion of the illumination light cone fills the length of the outercore 510 and the inner cores 505.

FIG. 5L illustrates the illumination beam spread out to totallyspatially fill the outer core 510. Similarly, FIG. 5M illustrates thedistal end of the multi-core optical fiber cable with the illuminationbeam spread across the outer cores 510 and the inner cores 505.

FIG. 5N illustrates the cut-away view of another multi-core opticalfiber cable 580 according to some embodiments of the present technology.The multi-core fiber cable 580 includes four germanium-doped silicainner core fibers 585 with a 75 micrometer diameter and a numericalaperture (NA) of 0.22 inside of a non-doped fused silica outer corefiber 590 having a 300 micrometer diameter and an NA of 0.47. The outercore fiber 590 can be contained within low-index polymer cladding 595having a 25 micrometer thickness. The multi-core optical fiber cable 580can be further contained in an Ethylene Tetrafluoroethylene (ETFE)coating 576.

The four germanium-doped silica inner core fibers 585 have a refractiveindex of substantially 1.47648 at 532 nanometers. The non-doped fusedsilica outer core fiber 590 have a refractive index of 1.46 at 532nanometers. The low-index polymer cladding 595 can have a refractiveindex of 1.38228 at 532 nanometers.

While specific geometries of the multi-core optical fiber cable areshown explicitly herein, those with ordinary skill in the art having thebenefit of the present disclosure will readily appreciate that a widevariety of configurations for the multi-core optical fiber cable arepossible. In the configuration shown in FIGS. 5A-5N, the whiteillumination spot at the distal end of the multi-core optical fiber issomewhat larger than the 2×2 array of laser spots. In some cases, thisgeometry is desired, because it provides illumination into both theretinal treatment target area as well as some surrounding retina andbecause the illumination spot small enough to keep the white lightfairly concentrated. Also, the geometry enables adequate whiteirradiance at the retina with a relatively small core diameter fiber.Furthermore, as explained above, the intensities of the whiteillumination and the laser aiming beams can be adjusted (e.g., at theIllumination Light Source and Surgical Laser System, respectively) toprovide the right amount of laser aiming beam contrast against the whitewhile providing enough white illumination to easily see the retina.

In some embodiments of the present technology, the distal end of themulti-core optical fiber cable terminates within a tip of a surgicalhand probe that is inserted into a patient's eye. The tip of thesurgical hand probe can also include a lens to image the multiplexedbeams onto patient anatomy, e.g. the retina.

FIG. 6A illustrates an open side view of a tip 605 of a surgical handprobe according to some embodiments of the present disclosure. The probetip 605 can comprise a cannula 635 (e.g. a stainless steel cannula) witha cannula distal end 630 and the probe tip containing the multi-coreoptical fiber 610 and a lens 615. The lens 615 can be a graded-index(GRIN) lens and an air gap 625 can be left open between the GRIN lens615 and the distal end of the multi-core optical fiber 610. The air gap625 can be sized such that the light emitted from the multi-core opticalfiber 610 experiences an amount of spread before falling incident on theGRIN lens 615 and such that the GRIN lens 615 images the light onto thepatient anatomy.

In some cases, no air gap is allowed between the distal end of themulti-core optical fiber 610 and the proximal end of the lens 615. Here,the multi-core optical fiber 610 and lens 615 are substantially buttedup against one other with positive pressure to avoid air-gap toleranceconcerns, allowing less chance for peripheral off-axis rays to travelfar enough off axis to reflect off of the cylindrical side wall of theGRIN lens. However, using a conventional lens instead of the GRIN lensinvolves an air gap between the multi-core optical fiber 610 and lens615 to focus the light properly.

In some cases, the lens 615 is secured within the probe tip 605 with anoptical adhesive 620. As shown in FIG. 6A, a multi-spot pattern ofgreen, 532 nm laser light is projected retinal tissue located 4millimeters from the cannula distal end 630.

FIG. 6B illustrates an open side view of another tip 640 of a surgicalhand probe according to some embodiments of the present disclosure.Again, the probe tip 640 can comprise a cannula 645 with a cannuladistal end 650 and the probe tip containing the multi-core optical fiber655 and a lens 660. The lens 660 illustrated in FIG. 6B is aPlano-convex glass lens. Also, the Plano-convex lens 660 is secured inthe cannula 635 by a retaining feature 665. Again, an air gap 670 can besized such that the light emitted from the multi-core optical fiber 655experiences an amount of spread before falling incident on thePlano-convex lens 660 and such that the Plano-convex lens 660 images thelight onto the patient anatomy.

FIG. 7 illustrates a method 700 of creating an image of a multiplexedbeam of multi-spot pattern of laser light beams and illumination lightin accordance with a particular embodiment of the present disclosure.The method involves: selecting materials for a multi-core optical fibercable to ensure confinement of the beams within the various core regionsas they propagate down the lengths fiber cable at step 705, as explainedabove. The method 700 also involves determining a numerical aperture oflaser light beams from a laser source and a numerical aperture of anillumination light beam from an illumination light source at step 725and selecting a condensing lens to focus the multiplexed multi-spotpattern of laser light beams and illumination beam onto an interfaceplane of the multi-core optical fiber cable at step 730.

Next, the method 700 involves multiplexing a multi-spot pattern of laserlight beams with the illumination light beam at step 735, focusing themultiplexed multi-spot pattern of laser light beams and illuminationbeam onto an interface plane of the multi-core optical fiber cable atstep 740, and directing the multiplexed beam of multi-spot pattern oflaser light beams and illumination light through a lens in the surgicalhandpiece at step 745.

As explained above, a wide variety of configurations for the multi-coreoptical fiber cable are possible. For example, an incoherent white lightillumination light source can be replaced with a white laser system(e.g., a supercontinuum laser system). In this case, the etendue of thewhite laser beam is small enough that it is less than the nanofiberetendue and can be efficiently coupled into the nanofiber, such that amulti-core optical fiber cable as described above can be used to delivermultiplexed laser aiming and treatment beams and white laserillumination.

FIGS. 8A-8D illustrate another example of a system for multiplexinglaser aiming and treatment beams and illumination light. FIG. 8Aillustrates an end view of a multi-lumen tubing 800 for deliveringmultiplexed laser aiming and treatment beams and a laser illuminationlight beam. The multi-lumen tubing 800 includes a central nanofiber 805and an array of glass laser fibers 810 contained within the multi-lumentubing 800. The central nanofiber 805 can be a large NA fiber forcarrying a white laser beam and the glass laser fibers 810 can be smalldiameter, small NA glass fibers for carrying laser aiming and treatmentbeams (e.g. red aiming beams and green treatment beams). In some cases,the central nanofiber 805 can be enclosed within a tiny-diameter, rigid,cylindrical or square, black absorptive or reflective cannula forstructural support, and can optionally be attached a focusing lens(described below) for structural support as well.

As shown in FIGS. 8B-8C, each of the laser aiming beams 806 and lasertreatment beams 807 as well as the laser illumination light beam 808will spatially underfill their respective fiber cores at the proximalend (FIG. 8B), but will totally fill their cores at the distal end (FIG.8C). In this case, in order to have the white laser illumination beamspatially larger than the multi-spot laser beam pattern at the retina,it is necessary to extend the distal end 820 of the nanofiber 815 pastthe distal end 825 of the array of glass fibers 810 in the multi-lumentubing 800 until the distal end 820 of the nanofiber 815 is at or near aproximal end of a focusing lens 830 (e.g., a plano-convex lens), asshown in FIG. 8D.

The above disclosed subject matter is to be considered illustrative, andnot restrictive, and the appended claims are intended to cover all suchmodifications, enhancements, and other embodiments which fall within thetrue spirit and scope of the present disclosure. Thus, to the maximumextent allowed by law, the scope of the present disclosure is to bedetermined by the broadest permissible interpretation of the followingclaims and their equivalents, and shall not be restricted or limited bythe foregoing detailed description.

What is claimed is:
 1. A method of multiplexing a multi-spot pattern of laser light beams with a illumination light beam comprising: directing a laser light beam to an optical element for collimating the laser light beam, the laser light beam having a wavelength contained within at least one of two narrow bands of an electromagnetic spectrum of light; directing the collimated laser light beam to a diffractive optical element (DOE) configured to create a multi-spot laser pattern of laser light beams; directing the multi-spot pattern of laser light beams to a beamsplitter; directing an illumination light beam to the beamsplitter, wherein the beamsplitter is configured to reflect the at least two narrow bands of the electromagnetic spectrum of light and transmit portions of the electromagnetic spectrum of light not contained within the at least two narrow bands of the electromagnetic spectrum, thereby multiplexing the multi-spot pattern of laser light beams and a transmitted illumination beam; directing the multiplexed multi-spot pattern of laser light beams and transmitted illumination beam to a condensing lens for focusing the multiplexed multi-spot pattern of laser light beams and transmitted illumination beam onto an interface plane of a proximal end of a multi-core optical fiber cable.
 2. The method of multiplexing a multi-spot pattern of laser light beams with a illumination light beam of claim 1, wherein the multi-core optical fiber cable comprises: a first outer core surrounded by an outer-core cladding; and a plurality of inner cores arranged within the outer core in a pattern that substantially matches the multi-spot pattern of laser light beams, wherein each inner core in the plurality of inner cores is surrounded by an inner-core cladding.
 3. The method of multiplexing a multi-spot pattern of laser light beams with a illumination light beam of claim 2, further comprising: selecting, for the multi-core optical fiber cable, a first material for the first outer core, a second material for the outer-core cladding, a third material for the plurality of inner cores, and a fourth material for the inner-core cladding.
 4. The method of multiplexing a multi-spot pattern of laser light beams with a illumination light beam of claim 3, further comprising: selecting the condensing lens to focus each of the laser beams in the multiplexed multi-spot pattern of laser light beams onto an interface with a respective inner core in the plurality of inner cores, wherein a spot size of each of the focused laser beams, an angular spread of each of the focused laser beams, a refractive index of the inner core, and a refractive index of the outer core causes the laser light beams to spatially fill and propagate the plurality of inner cores for the length of the multi-core optical fiber cable.
 5. The method of multiplexing a multi-spot pattern of laser light beams with a illumination light beam of claim 2, further comprising: selecting the condensing lens to focus the illumination beam as a light cone with a spot size that falls on the interface plane of a proximal end of a multi-core optical fiber cable, wherein the spot size falls incident on at least a portion of the first outer core, at least a portion of the plurality of inner cores, and at least a portion of the inner-core claddings. wherein the light cone includes a narrow half-angle portion of the light cone and a wide half-angle portion of the light cone.
 6. The method of multiplexing a multi-spot pattern of laser light beams with a illumination light beam of claim 4, wherein a refractive index of the first outer core, a refractive index of the plurality of inner cores, a refractive index of the inner-core cladding, and an angle of the narrow half-angle portion of the light cone causes the illumination beam to spatially fill and propagate the length of the outer core.
 7. The method of multiplexing a multi-spot pattern of laser light beams with a illumination light beam of claim 4, wherein a refractive index of the outer core, a refractive index of the plurality of inner cores, a refractive index of the inner-core claddings, and an angle of the wide half-angle portion of the light cone causes the illumination beam to spatially fill and propagate the outer core for the length of the multi-core optical fiber cable.
 8. The method of multiplexing a multi-spot pattern of laser light beams with a illumination light beam of claim 1, wherein the multi-core optical fiber cable comprises: a first outer core surrounded by an outer-core cladding; and a plurality of inner cores arranged within the outer core in a pattern that substantially matches the multi-spot pattern of laser light beams.
 9. The method of multiplexing a multi-spot pattern of laser light beams with a illumination light beam of claim 8, further comprising: selecting the condensing lens to focus each of the laser beams in the multiplexed multi-spot pattern of laser light beams onto an interface with a respective inner core in the plurality of inner cores, wherein a spot size of each of the focused laser beams, an angular spread of each of the focused laser beams, a refractive index of the inner core, and a refractive index of the outer core causes the laser light beams to spatially fill and propagate the plurality of inner cores for the length of the multi-core optical fiber cable.
 10. The method of multiplexing a multi-spot pattern of laser light beams with a illumination light beam of claim 8, further comprising: selecting the condensing lens to focus the illumination beam as a light cone with a spot size that falls on the interface plane of a proximal end of a multi-core optical fiber cable, wherein the spot size falls incident on at least a portion of the first outer core and at least a portion of the plurality of inner cores, wherein the light cone includes a narrow half-angle portion of the light cone and a wide half-angle portion of the light cone.
 11. The method of multiplexing a multi-spot pattern of laser light beams with a illumination light beam of claim 8, wherein a refractive index of the first outer core, a refractive index of the plurality of inner cores, a refractive index of the inner-core cladding, and an angle of the narrow half-angle portion of the light cone causes the illumination beam to spatially fill and propagate the length of the outer core.
 12. The method of multiplexing a multi-spot pattern of laser light beams with a illumination light beam of claim 8, wherein a refractive index of the outer core, a refractive index of the plurality of inner cores, a refractive index of the inner-core claddings, and an angle of the wide half-angle portion of the light cone causes the illumination beam to spatially fill and propagate the outer core for the length of the multi-core optical fiber cable.
 13. The method of multiplexing a multi-spot pattern of laser light beams with a illumination light beam of claim 1, further comprising: directing, at the distal end of the multi-core optical fiber cable, the multiplexed multi-spot pattern of laser light beams and transmitted illumination beam onto a lens in a probe tip, wherein the lens translates a geometry of the multiplexed multi-spot laser pattern of laser light beams and illumination beam from the distal end of the multi-core optical fiber cable onto a target surface.
 14. The method of multiplexing a multi-spot pattern of laser light beams with a illumination light beam of claim 1, further comprising: adjusting an intensity of the surgical treatment beam and an intensity of the aiming beam are adjusted to produce a clear multiplexed multi-spot laser pattern of laser light beams and illumination beam on the surface. 